Article
Peripheral Vascular Disease
Gregory L. Hundemer, Haris Imsirovic, Tetyana Kendzerska, Anand Vaidya, Alexander A. Leung, Gregory A. Kline, Remi Goupil, Francois Madore, Mohsen Agharazii, Greg Knoll, Manish M. Sood
Summary: It remains unknown whether the recommendation to screen patients with hypertension plus obstructive sleep apnea (OSA) for primary aldosteronism (PA) is being implemented in clinical practice. Only a small proportion of patients underwent PA screening.
AMERICAN JOURNAL OF HYPERTENSION
(2023)
Review
Clinical Neurology
Josephine McCarthy, Jun Yang, Ben Clissold, Morag J. Young, Peter J. Fuller, Thanh Phan
Summary: Primary aldosteronism carries a higher risk of stroke, atrial fibrillation, and cardiovascular disease compared to essential hypertension. While there are targeted treatments and potentially curative surgical options for primary aldosteronism, there is a lack of guidelines for screening and diagnosing the condition in stroke patients with hypertension. However, accurate diagnosis of primary aldosteronism could lead to improved blood pressure control and reduced cardiovascular risk in this population.
Article
Endocrinology & Metabolism
Tazuru Fukumoto, Hironobu Umakoshi, Masatoshi Ogata, Maki Yokomoto-Umakoshi, Yayoi Matsuda, Misato Motoya, Hiromi Nagata, Yui Nakano, Norifusa Iwahashi, Hiroki Kaneko, Norio Wada, Takashi Miyazawa, Ryuichi Sakamoto, Yoshihiro Ogawa
Summary: This study aimed to explore the role of two confirmatory tests in the subtype diagnosis of primary aldosteronism (PA). The results showed that patients with discordant results between confirmatory tests are highly likely to have a bilateral subtype on adrenal vein sampling (AVS).
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2021)
Review
Peripheral Vascular Disease
Ute Scholl
Summary: Primary aldosteronism is the most common cause of secondary hypertension, largely due to genetic mutations in ion channels and pumps. Somatic mutations are responsible for sporadic cases, while germline mutations cause familial hyperaldosteronism.
Review
Peripheral Vascular Disease
Viola Sanga, Giacomo Rossitto, Teresa Maria Seccia, Gian Paolo Rossi
Summary: This study aims to diagnose primary aldosteronism in pregnancy (PAP) and provide management suggestions based on the evidence obtained. A nomogram was developed to identify PAP cases based on the changes in aldosterone and renin. PAP cases were classified into four groups with different management and outcomes. Adrenalectomy did not improve maternal and fetal outcomes compared to medical treatment alone. Early detection and surgical treatment of unilateral PAP resulted in better outcomes for maternal hypertension and mother and baby outcomes.
Article
Medicine, General & Internal
Umberto Anceschi, Marilda Mormando, Rocco Simone Flammia, Cristian Fiori, Orazio Zappala, Bernardino De Concilio, Aldo Brassetti, Alessandro Carrara, Maria Consiglia Ferriero, Gabriele Tuderti, Leonardo Misuraca, Francesco Prata, Antonio Tufano, Alfredo Maria Bove, Riccardo Mastroianni, Marialuisa Appetecchia, Giuseppe Tirone, Francesco Porpiglia, Antonio Celia, Giuseppe Simone
Summary: This study evaluated the ability of therapeutic intensity score (TIS) in predicting the clinical outcomes of partial (PA) and total adrenalectomy (TA) for unilateral persistent adrenal mass (UPA). The results showed that TIS score and adenoma size may help to identify patients who are likely to be at risk of persistent hypertension after surgery.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Endocrinology & Metabolism
Sumaiya Ahmed, Gregory L. Hundemer
Summary: Primary aldosteronism is the most common and modifiable form of secondary hypertension. Early diagnosis and targeted therapy are crucial for improved long-term patient outcomes. Surgical adrenalectomy is the recommended treatment for unilateral primary aldosteronism, offering the potential for disease cure.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Van Nguyen, Tian Ming Tu, Marlie Jane B. Mamauag, Jovan Lai, Seyed Ehsan Saffari, Tar Choon Aw, Lizhen Ong, Roger S. Y. Foo, Siang Chew Chai, Shaun Fones, Meifen Zhang, Troy H. Puar
Summary: The study assessed the prevalence of primary aldosteronism (PA) in stroke patients and found a higher prevalence in patients with atrial fibrillation or cardioembolic stroke. Screening for PA is recommended for all stroke patients.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Review
Cardiac & Cardiovascular Systems
Shivaraj Patil, Chaitanya Rojulpote, Aman Amanullah
Summary: Cardiovascular disease, especially ischemic heart disease, is a major global cause of illness and death. Primary aldosteronism is the main cause of secondary hypertension, but it is often under-diagnosed. Recent studies have shown that excessive production of aldosterone is associated with an increased risk of ischemic heart disease, which is disproportionate to the effects caused by hypertension alone. Understanding primary hyperaldosteronism and the distinctive pathophysiology of ischemic heart disease in this condition is crucial for improving outcomes.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Endocrinology & Metabolism
Martina Tetti, Siyuan Gong, Franco Veglio, Martin Reincke, Tracy Ann Williams
Summary: Primary aldosteronism is the most common surgically curable form of hypertension. Recent advances in our understanding of the disease have focused on the underlying genetic variants that cause excess aldosterone production. The mechanisms of increased adrenal cortex mass are still not well understood, but the application of transcriptomics, metabolomics, and epigenetics has provided valuable insights.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Peripheral Vascular Disease
Lucie S. Meyer, Laura Handgriff, Jung Soo Lim, Aaron M. Udager, Isabella-Sabrina Kinker, Roland Ladurner, Moritz Wildgruber, Thomas Knoesel, Martin Bidlingmaier, William E. Rainey, Martin Reincke, Tracy Ann Williams
Summary: In surgically treated patients with unilateral primary aldosteronism, there are differences in histopathology, genotype, and postsurgical outcomes between classical and nonclassical groups. Patients with nonclassical histopathology have a higher incidence of postsurgical disease persistence and increased aldosterone production from the unresected gland.
Article
Peripheral Vascular Disease
Kohei Saito, Isao Kurihara, Hiroshi Itoh, Takamasa Ichijo, Takuyuki Katabami, Mika Tsuiki, Norio Wada, Takashi Yoneda, Masakatsu Sone, Kenji Oki, Tetsuya Yamada, Hiroki Kobayashi, Kouichi Tamura, Yoshihiro Ogawa, Junji Kawashima, Nobuya Inagaki, Koichi Yamamoto, Masanobu Yamada, Kohei Kamemura, Yuichi Fujii, Tomoko Suzuki, Akihiro Yasoda, Akiyo Tanabe, Mitsuhide Naruse
Summary: The study revealed significant changes in the clinical characteristics of primary aldosteronism subtypes APA and BAH from 2006 to 2018. APA patients tended to be diagnosed earlier and in milder forms, while BAH patients showed decreases in hypertension duration and hypokalemia prevalence.
JOURNAL OF HYPERTENSION
(2021)
Article
Medicine, General & Internal
Umberto Anceschi, Marilda Mormando, Cristian Fiori, Orazio Zappala, Bernardino De Concilio, Aldo Brassetti, Alessandro Carrara, Maria Consiglia Ferriero, Gabriele Tuderti, Leonardo Misuraca, Alfredo Maria Bove, Riccardo Mastroianni, Alfonsina Chiefari, Marialuisa Appetecchia, Giuseppe Tirone, Francesco Porpiglia, Antonio Celia, Michele Gallucci, Giuseppe Simone
Summary: A study proposed a trifecta as a predictor for postoperative endpoints and their maintenance after adrenalectomy in patients with unilateral primary aldosteronism. The trifecta includes changes in antihypertensive therapeutic intensity score, absence of hypokalemia, and absence of Clavien grade 2-5 complications. The study found that the trifecta and adenoma size are independent predictors of long-term success in clinical, biochemical, or combined aspects after adrenalectomy for unilateral primary aldosteronism.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Peripheral Vascular Disease
Kyoung Jin Kim, Namki Hong, Min Heui Yu, Hokyou Lee, Seunghyun Lee, Jung Soo Lim, Yumie Rhee
Summary: The risk of new-onset atrial fibrillation remains elevated up to 3 years in patients with primary aldosteronism compared with essential hypertension, especially peaking at 1 year, and gradually declining afterwards to levels comparable with essential hypertension. Monitoring for atrial fibrillation up to 3 years after treatment, particularly in patients who underwent adrenalectomy, may be necessary.
Review
Biochemistry & Molecular Biology
Yuta Tezuka, Yuto Yamazaki, Yasuhiro Nakamura, Hironobu Sasano, Fumitoshi Satoh
Summary: Primary aldosteronism (PA) has been recognized as a leading cause of secondary hypertension, with two major subtypes clinically identified as surgically curable and uncurable, requiring time-consuming and labor-intensive diagnostic procedures. Recent research has focused on PA prevalence, histopathological classification, diagnostic biomarkers, and prediction scores, aiming to improve early detection and decrease complications through better understanding of its epidemiology and pathology.
Review
Substance Abuse
Emma Ritchie, Chelsea Fitzpatrick, Paul E. Ronksley, Alexander A. Leung, Sydney Seidel, Daniel S. McGrath
Summary: The study found that alcohol cue exposure can increase cravings for tobacco, but only a small percentage of studies showed that alcohol cue exposure leads to increased smoking behavior. There is significant heterogeneity between studies, including differences in alcohol cue exposure methods, measures of tobacco cravings, participant and study characteristics.
ALCOHOL AND ALCOHOLISM
(2022)
Article
Endocrinology & Metabolism
Gregory A. Kline, Benny So, David J. T. Campbell, Alex Chin, Adrian Harvey, Erik Venos, Janice Pasieka, Alexander A. Leung
Summary: An algorithm was developed using biochemical data from AVS and CT images to detect cortisol cosecretion as a potential explanation for discordant lateralisation results in PA. Applied to discordant cases, the algorithm suggested possible cortisol cosecretion in 40% of cases, indicating that cortisol cosecretion from aldosteronomas may be a common explanation for discordant results.
CLINICAL ENDOCRINOLOGY
(2022)
Article
Peripheral Vascular Disease
Davis Sam, Gregory A. Kline, Benny So, Gregory L. Hundemer, Janice L. Pasieka, Adrian Harvey, Alex Chin, Stefan J. Przybojewski, Cori E. Caughlin, Alexander A. Leung
Summary: This study assessed the performance of clinical prediction models for subtyping primary aldosteronism (PA). The study found that these models did not accurately predict adrenal vein sampling (AVS) lateralization in a large cohort, indicating that they cannot be reliably used to inform the decision to pursue AVS for most patients.
AMERICAN JOURNAL OF HYPERTENSION
(2022)
Article
Cardiac & Cardiovascular Systems
Alexander A. Leung, Jeanne V. A. Williams, Karen C. Tran, Raj S. Padwal
Summary: Around 5.3% of Canadian adults treated for hypertension have apparent treatment-resistant hypertension. Despite being prescribed multiple antihypertensive drugs, especially women, they still have difficulty achieving blood pressure control, predisposing them to a higher risk of cardiovascular complications and death.
CANADIAN JOURNAL OF CARDIOLOGY
(2022)
Article
Medical Laboratory Technology
Gregory A. Kline, Jessica Boyd, Martin Hyrcza, Daniele Pacaud, Janice L. Pasieka, Yuan Dong, Hossein S. M. Sadrzadeh, Alexander A. C. Leung
Summary: The study found that using higher age-stratified reference intervals for the 24 h UNM test did not compromise test sensitivity for true pheochromocytoma cases, while significantly reducing the false positive rate.
CLINICAL BIOCHEMISTRY
(2022)
Review
Radiology, Nuclear Medicine & Medical Imaging
C. B. So, A. A. Leung, A. Chin, G. A. Kline
Summary: This article discusses the operator's experience with adrenal vein sampling as an important step in diagnosing primary aldosteronism, and explores new developments and technical enhancements in the field. Understanding variant anatomy and successful cannulation techniques are critical to achieving success, along with collaboration with endocrinology and clinical chemistry for quality control.
CLINICAL RADIOLOGY
(2022)
Review
Gerontology
Kayla Atchison, Samreen Shafiq, Delaney Ewert, Alexander A. Leung, Zahra Goodarzi
Summary: This study aimed to identify the diagnostic tools for anxiety disorders in residents of long-term care facilities, and found that the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale-Anxiety section showed the best performance in detecting generalized anxiety disorder. This provides important reference for diagnosing and managing anxiety in long-term care residents.
CANADIAN JOURNAL ON AGING-REVUE CANADIENNE DU VIEILLISSEMENT
(2023)
Article
Health Care Sciences & Services
Yuanchao Feng, Alexander A. Leung, Xuewen Lu, Zhiying Liang, Hude Quan, Robin L. Walker
Summary: This study compared the performance of four machine learning approaches for personalized prediction of incident hospitalization for cardiovascular disease among newly diagnosed hypertensive patients. The results showed that these methods provide similar discrimination and calibration in the personalized survival prediction of hospitalizations for cardiovascular events in patients with hypertension.
BMC MEDICAL RESEARCH METHODOLOGY
(2022)
Review
Obstetrics & Gynecology
Sophie Cartier, Gina-Marie Cerantola, Alexander A. Leung, Erin Brennand
Summary: This review evaluates the association between surgeon operative volume and the risk of reoperation after mid-urethral sling (MUS). The results indicate that patients who undergo surgery by low-volume surgeons have a higher risk of mesh removal/revision and repeated incontinence procedures. However, caution should be taken in interpreting the results due to the varying definitions of low-volume and high-volume surgeons.
INTERNATIONAL UROGYNECOLOGY JOURNAL
(2023)
Review
Agriculture, Dairy & Animal Science
Ellen de Jong, Lien Creytens, Sarne De Vliegher, Kayley D. Mccubbin, Mya Baptiste, Alexander A. Leung, David Speksnijder, Simon Dufour, John R. Middleton, Pamela L. Ruegg, Theo J. G. M. Lam, David F. Kelton, Scott Mcdougall, Sandra M. Godden, Alfonso Lago, Paeivi J. Rajala-Schultz, Karin Orsel, Volker Kroemker, John P. Kastelic, Herman W. Barkema
Summary: In the treatment of clinical mastitis, selective treatment protocols have been found to be noninferior to blanket treatment protocols in terms of bacteriological cure. However, the impacts on clinical cure, new infections, somatic cell count, milk yield, recurrence, and culling are still inconclusive. A systematic review of 13 studies suggests that, except for clinical cure, a selective treatment protocol does not adversely affect other outcome measures. Further research with better randomization is needed to confirm these findings.
JOURNAL OF DAIRY SCIENCE
(2023)
Review
Public, Environmental & Occupational Health
Tanis R. Fenton, Seham Elmrayed, Natalie V. Scime, Suzanne C. Tough, Jahaira Pinto, Fatemeh Sabet, Krista Wollny, Yoonshin Lee, Tyrone G. Harrison, Bibi Alladin-Karan, Michael S. Kramer, Maria B. Ospina, Diane L. Lorenzetti, Ada Madubueze, Alexander A. Leung, Manoj Kumar
Summary: Historical reports suggest that infants born small for gestational age (SGA) are at increased risk for high blood pressure (BP) at older ages. However, this study found no meaningful difference in later BP between preterm infants with and without SGA status at birth.
PAEDIATRIC AND PERINATAL EPIDEMIOLOGY
(2023)
Article
Peripheral Vascular Disease
Gregory L. Hundemer, Haris Imsirovic, Tetyana Kendzerska, Anand Vaidya, Alexander A. Leung, Gregory A. Kline, Remi Goupil, Francois Madore, Mohsen Agharazii, Greg Knoll, Manish M. Sood
Summary: It remains unknown whether the recommendation to screen patients with hypertension plus obstructive sleep apnea (OSA) for primary aldosteronism (PA) is being implemented in clinical practice. Only a small proportion of patients underwent PA screening.
AMERICAN JOURNAL OF HYPERTENSION
(2023)
Review
Public, Environmental & Occupational Health
Seham Elmrayed, Jahaira Pinto, Suzanne C. Tough, Sheila W. McDonald, Natalie Scime, Krista Wollny, Yoonshin Lee, Michael S. Kramer, Maria B. Ospina, Diane L. Lorenzetti, Ada Madubueze, Alexander A. Leung, Manoj Kumar, Tanis R. Fenton
Summary: There is an association between being born small for gestational age (SGA) and later adiposity and height among those born preterm. Preterm SGA infants have lower BMI, waist circumference, lean body mass, and height in later life compared to their non-SGA peers.
PAEDIATRIC AND PERINATAL EPIDEMIOLOGY
(2023)
Article
Public, Environmental & Occupational Health
Mursal A. Mohamud, David J. T. Campbell, James Wick, Alexander A. Leung, Gabriel E. Fabreau, Marcello Tonelli, Paul E. Ronksley
Summary: This study aimed to describe the trends in multimorbidity and the differential contribution of individual chronic conditions to multimorbidity among hospitalized populations in the United States. The study found that there was an increase in multimorbidity among all racial/ethnic groups from 1993 to 2012, with the largest increases seen in White, Black, and Native American populations. Additionally, metabolic diseases, particularly diabetes and obesity, had an increasing contribution to multimorbidity, especially among Hispanic patients.
INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH
(2023)
Article
Multidisciplinary Sciences
Mohammad Ziaul Islam Chowdhury, Alexander A. A. Leung, Robin L. L. Walker, Khokan C. C. Sikdar, Maeve O'Beirne, Hude Quan, Tanvir C. C. Turin
Summary: This study evaluates different machine learning algorithms and compares their predictive performance with the conventional Cox proportional hazards (PH) model to predict hypertension incidence using survival data. The study found that in a moderate dataset with a reasonable number of features, conventional regression-based models perform similar to machine learning algorithms with good predictive accuracy.
SCIENTIFIC REPORTS
(2023)